What is Mental Health?

• What Is Mental Health?
  
• How Do I Know If My Child Needs Help?
  
• Where Do I Start?
  
• What Do I Do in an Emergency?
  
• Whom Can I Call?
  
• What Does Therapy Look Like?
  
• What Happens After Therapy?
  
• It’s Normal to Be Scared or Anxious

What Is Mental Health?

Mental health is often described as how we feel and act -- our behavior, mood, and attitude toward our lives and our surroundings. We often reveal our mental health through our ability to cope and respond to stress, how we relate to family and friends, and how we operate at home, work, or school.

In the case of the children and families who Trillium serves, however, mental health refers to much more than a boy or girl having a bad day. When we talk about mental health and mental health care, it’s no different than when we talk about physical health and our physical health care system.

That’s because mental health and physical health are similar. Mental illness or a mental health condition can be brought about by stress and other external factors such as neglect or abuse -- just as physical health is affected by these same factors. Abuse, for example, can lead to physical injuries and emotional injuries.

And just as with physical health, there are factors that affect our mental health that are outside of our control. Brain chemistry, genetics, biology, and environmental factors all affect both physical and mental health. Just as a child is prone to diabetes because of genetics, a boy or girl can be predisposed to a mental illness. Like physical health, mental health is not dependent on a family’s economic status or stability, which is why we see families from all walks of life.

There is one difference between mental health and physical health, however. A mental illness displays itself through behavior and mood, among other ways. Even today, mental illness is often looked upon as a character flaw rather than a treatable condition that can be effectively managed.

We do know that mental illness is treatable, especially in children. The symptoms and severity of a mental health condition can range from mild to severe, just as the symptoms for a child with diabetes. If caught early enough and addressed properly, a mental health condition can be imperceptible to the outside world because it can be effectively managed. The same with diabetes, for example.

If left untreated, however, the condition can become severe. A child’s and family’s life can become tumultuous, and families can be torn asunder as they attempt to find appropriate help.

A final note of reassurance -- mental health problems are not uncommon. About 1 in 5 young people suffer with a diagnosable mental health condition at any given time -- that’s 20 percent of children.

This isn’t a new phenomenon or the result of over-diagnoses, as some popular media would have us believe. What is new is that society is finally shining a light on mental health care, and the stigma surrounding mental health services is lifting. More people are free to acknowledge they need mental health services and get the help they need.

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How Do I Know If My Child Needs Help?

Sometimes it is difficult for a parent to separate what is normal behavior from signs that a child may be suffering with a mental health issue. As one mother told us, her family and friends referred to her rambunctious boy as Dennis the Menace. He was cute and loving, but he caused problems everywhere he went because of his behavior. Over time, it became clear his behavior “just wasn’t right,” as his mom says.

Signs can be even tougher to spot in pre-teens and teen-agers, two difficult age periods in which new social pressures add “drama” to their lives, among other influences that youth must assimilate and cope with. Another mother who called with questions about her son wondered what is normal moody behavior for her 15-year-old vs. clear signals of depression.

Problems with anger, lack of control over impulses, and oppositional behaviors are often warning signs. Some children with oppositional disorders simply can’t be parented, as some families have described. Sudden changes in behavior also can be signs. An extrovert who becomes withdrawn, for example, or an academically well-performing student whose grades drop quickly. Behaviors may become more erratic and unpredictable and pose a risk to the child and those around him or her.

In more severe cases, parents may see in their children an inability to process. A child “just doesn’t get it.” “If only you’d listen” or “why don’t you understand” are refrains that parents have used on their children before coming to Trillium.

Common disorders among children include attention deficit hyperactivity disorder, depressive disorders, oppositional defiant disorders, post traumatic stress syndrome, and anxiety disorders. See our Web Resources for Families for more information on specific disorders.

Because mental health conditions impact the most complex organ in our body -- our brain -- there often isn’t some magic sign that signals your child needs help. There is no parenting manual that spells it out.

If you have concerns, empower yourself. Call Trillium or another provider. We hear similar questions and concerns every day and help families navigate these sometimes uncertain waters.

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Where Do I Start?

The easiest place for most families to start is with their family physician, the doctor who may know your family and child best. Keep in mind, this is only a place to start in many cases.

Share freely with your doctor. It’s normal to feel embarrassed, as if you are being judged as a parent. Rest assured, you aren’t the first or last parent who feels this way. Almost every family who comes to Trillium shares similar sentiments.

You may wish to insist on a referral to an expert in children’s mental health. Many families follow up a visit to their doctor or even start by “self-referring,” which is directly contacting a provider such as Trillium to schedule an appointment or an assessment, where our team of professionals can analyze your child’s condition and suggest appropriate therapy. Often, this therapy is done in tandem with any medical treatment that your doctor recommends. And therapy generally involves the whole family and other important figures in your child’s life, such as teachers and school counselors.

Starting in January 2007, families with health insurance provided through their employers in Oregon will have new abilities to access mental health services without barriers. Thanks to a new law in Oregon, insurance benefits for physical health and mental health will be equal -- you may see a mental health therapist as easily as your regular doctor and the visit is covered by the same system of deductibles or co-pays.

Families do have to work harder to get appropriate mental health services. Advocates for patients call the mental health system the forgotten stepchild in our total health care system.

If you hurt you knee and see your doctor, for example, he or she may refer you to a specialist. Depending on your insurance and your clinic, a process may be in place to identify a specialist and your clinic may even schedule your first appointment. The idea is to make it easy for a patient to get appropriate services.

Such a process is sadly lacking in mental health care, which is why you may need to be persistent. Families need to be advocates for their children and actively pursue therapy options.

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What Do I Do in an Emergency?

If you child is in the midst of a crisis -- if your child’s behaviors present an immediate risk to his or her safety or the safety of others -- it’s best to call 9-1-1 for medical assistance. Your child may be taken to the emergency room for evaluation and, in some cases, hospitalized for evaluation. However, hospitals are not equipped to treat mental health patients for very long.

If your child’s condition is severe enough, he or she may need a level of psychiatric residential care called “sub-acute” care, which is sometimes referred to as an alternative to hospitalization. As mentioned above, you may have to be your child’s advocate -- some emergency rooms, even at hospitals that specialize in children’s services, may not know about Trillium and other resources in the community that can provide the appropriate level of care. You have to feel empowered enough to inquire about services.

Families may also find that their children need a higher level of care because children can no longer function successfully or safely at home. A small percentage of the children we evaluate need what is called traditional psychiatric residential care, where they live at one of our campuses in a safe, secure, and comfortable environment.

Some children need this structured environment in which to begin therapy before progressing to lower levels of care and returning to their everyday settings at home and in school.

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Whom Can I Call?

If you feel lost in the “system,” you should call Trillium Family Services or another trusted provider in your community. You may reach Trillium toll-free at 888-333-6177.

There are also several advocacy groups in Oregon who may serve as a resource. NAMI Oregon is the state chapter of the National Alliance on Mental Illness, a group dedicated to advancing an agenda of treatment and understanding for children and adults suffering with mental illness. The organization is composed of volunteers who all have experience with Oregon’s mental health system.

NAMI Oregon can be reached in the Portland Metro area at 503-230-8009 or toll-free at 800-343-6264.

The Oregon Family Support Network is another great resource for families. The nonprofit group is composed of families ready to help other families struggling with the mental health of their children. The group can be reached toll-free at 800-323-8521.

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What Does Therapy Look Like?

Health care providers such as Trillium use the term “family-centered” to refer to the care we offer. The term refers to our willingness to engage the entire family in treatment. In the end, once children return home, families are the primary caregivers and managers of a child’s ongoing needs.

There are several levels of care, ranging from residential to outpatient therapy. We list these broad categories of care on our Website and include more information there.

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What Happens After Therapy?

With mild conditions, children may never need treatment again once a family is in tune with a child’s needs. Other children may need ongoing medication management and/or periodic therapy as they grow older.

With other children who reach a crisis state, once they complete therapy, they also may only need periodic services. One mother whose son required residential treatment today takes him to his primary physician four times a year for medication management. If his condition changes, she knows where to turn first for help to prevent a future crisis.

In the most severe cases, children may face their illness throughout their lifetime. One mother who works at Trillium first came to Trillium’s residential program when her daughter, Natalie,  was diagnosed as schizophrenic, a condition that is very rare in children. Success for Natalie looks like this -- she struggles, but she has traveled and studied abroad. She lives independently in a different city than her mother. But her mother must be diligent in looking after her because Natalie’s condition can worsen without much warning.

All of these examples are success stories because children live as normal a life as possible and have the freedom to fulfill their potential. And families are armed with the knowledge and access to services they need to help their children be successful.

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It’s Normal to Be Scared or Anxious

Coping with a child’s mental health disorder and finding appropriate treatment are difficult tasks when a family is under stress. Family members, friends, neighbors and others may not understand what your family is dealing with. It may seem that outsiders are judging your abilities as a parent and casting blame.

You may feel isolated as you try to help your child. But you are not alone.

Take the first step. Call your physician. Call Trillium Family Services. Call one of the advocacy groups listed above. There are families and mental health professionals willing to help. They understand, and they are willing to provide the comforting and confidential support that your child, your family and you need.

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